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HomeMy WebLinkAbout13478-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z13886 Date September 30 1985 THIS CERTIFIES that the building ....0 .n,e., .f .a .m.i. 1. y...r.e.s.i..d .e.n.c. e, ..................... Location of Property 1650 Albo Drive Laurel House No. Street Ham/et County Tax Map No. 1000 Section .... 1.2..6 ..... Block 03 .Lot 07 S '. dM pN ....... ubdivision .............................. File a o. ,Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... S.e.l~ ~;,. 2.6. ........ 19 .~.4. pursuant to which Building Permit No. 1 3 6 7 8 Z dated ..... D.c.t;,. J .9 ............... 19 8..4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... 0~9 family residence .a.~.t~.c.h.e..d.~a.r..ag.e. ....................................... .. ........... The certificate is issued to THOMAS G~iNNON ..................... x .................. of the aforesaid building. Suffolk County Department of Health Approval 16-S0-186 9/30/85 UNDERWRITERS CERTIFICATE NO ............... .N.6. 9..1 .~.7.6. .... 5 / 13/85 Plumbers Certificate 9/12/85 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE'rlON OF THE WORK AUTHORIZED) 13478 Z Permission is hereby granted to: .......... ~...~.~..~.. ......... ~.... ........................... ..... ~0...,.../.;~.~ ......... ~.~ ....................... .... . ./.~...~..~/.-....-....~.~ .................. .~e~.~..~. ..... ' ~.,~Z~'~..~ '- ~o.. ~.cz......~..,L~.......~.,~/ ~ .... ~.~:~. ................................................... ~ .......................... ~- ~."i ..... iiiii~i~Z.L'""~.~ .... at premises located at :~.L~..~..~.......~...~..~.~..(~. ............, ....... ..... y .............. County Tax Map No. 1000 Section ...,~,.,~,,,~. ....... Block .... .~,~, ......... Lot No....,O,.,~,,.Z ....... pursuant '0 applicoflon dated ...~...~.Z~.......,~...~.. ................... , 1 .~,..~.., and approved by the Building Inspector. ' B6ildlng Inspector Rev. 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~1~[1~1~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusuat natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pJtoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 / 3. Copy of certificate of occupancy $1.00 / , ~, 4.Vacant Land .O. $5.00 -~ /C-~'~ a~/C~ . Date .... .~/~, .d ,~/.O. ? ......... New Building ... V ....... Old or Pre-existing Building ............. Vacant Land ............. Location of Property ..l~~ ..... ~.~' .... .~ ...... , .... ~,~/.~"~ .... L ............. · House No. Street Ham/et Owner or Owners of Property ~'-/~. '~ .~ .... ~:~12 ~ ............................... County Tax Map No. 1000 Section .../F.,~ ....... Bl6ck...0.~, ........ Lot.. ,(~,,~p .......... Subdivision ................................. Filed Map No ........... Left,Jo .............. Permit No, . .L .... ate of Permit . ,Applicant .......... ' App Health Dept. Approval .......... Labor Dept. reval ........................ Underwriters Approval .~.~.~,~.~.?.7~::7 .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ~:;~ ~ o-o Rev. 10-10-70 ~' ~ STEVEN E. BURNS Plumbing & Heating BOX 161, POINT STREET. SOUTH JAMESPORT, N.Y. 11970 I~c. # 1887 PLUMBER'S WORK ORDER c,~ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner Plumber (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this Notary Public, , ~& County HELEN IL DE VOE NOTARY PUBLIC, State of New Ifed~ No. 4707878, Suffolk Courd~;. ~; lerm £xpi~'e~ Ma~ch 30,19_ ~,J Notary Public .~oou~.~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-- Ol 85 JOHN STREET, NEW YORK, NEW YORK 100~8 ~.~~ ~, ~ ~..~.,,o.~o.o.~.~ ~0~/~ N 69~476 THIS CE~IFIES THAT only the alee tricel equipment as described below and introduced by tl~ applicant named on the aboee application number in the premises of in the/ollowing location; ~ Basement ~ 1st Fl. ~ 2nd Fl. Section Block Lot was examined on ~ ~ ~ ~ and found to be in compliance with ¢he reqt*~reme~ts o~ this Board. EIX?URE OUTLETS 21 FIXTURES SWITCHES NCANDE$CENT FLUORESCENT VAPOR 31 16 2i DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET RANGES ~OOKING DECKS OVENS DISH WASHERS EXHAUST FANS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: NO OF CC. COND. A W G NO OF HI.LEG A W.G. NO. OF NEUTRALS A W, G, pER ~/ OF CC COND OF HI-LEO O5 NEUTRAL 1 Z .t. 2 ~,~,e Ele¢~rio~l Cont. lnc Box 1~4, ~in Ikl 785 E GENERA[ MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto/s may be identified by their credentials. coulD. B? ~, , , ,. FIELD /. INSPECT;ON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY GODE k FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~.. [. 7 ..... ,1 ~ -'7' Approved..~...'.../.~. ..... , 1 .~. · Permit No./.~. · .~-Z~.' ],~~xx~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... .... BLDG. DEPT. TOWN OF $OUTHOLD Received ........... ,lg.._ , ., 19g'.f. INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing, code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~.~.gs. ,,)/-,/Jif, ,q ~~~m e, if a corporation) (Mailing address of applicant) State_whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. Name of owner of premises .'.'7f4oo'~ oS..~J..,~.rt, O0,'3 .....~. ./.~.l.r¢.. 4.t' .r~. .T... .03 ~ .'?~.0~ t. . .,' . . ././..7.~ ~ ....... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..¢q.~. ~.0~..q~...~[,\.~..~. Plumber's License No..~.....~.. ~i. Electrician's License No. fi... ~. ....... (/. ........ Other Trade's License No.' ': .................... Location of land on which proposed work will be done. k.~.~.., 0[[~..'~"... A.~.. X .~t~.-:( ............... · ........................ ........... .................. House Number Street Hamlet County Tax Map No. I000 Section ... !'.A.~. ......... Block ..O...~. ........... Lot...O..~7 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .. ~', .~.* :.~x. ~. ~ .~. .................................................. 3.. ature of work (check which applicable): New Building . ../,~.'. .... Additio .......... Alteration ......... Repair ........ Re~oval ......... Demolition n. Other Work ...... ! ~ "! c_~ (Description) 4. ~stnnated Cost ......................... Fee .... ' ....................... -;2. : ,. ,~o [~i *'. (to be paid on filing this lieation) 5. '.~d.llltl~i.~ng;,numb~~ u,,mts .... .~. .... Number of dwelling units on each floor ................ If garage, number of cars .... ~ ................................................................. 6. If business, commercial or mix4d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurbs, ifany: Front......"~'~... ...... Rear /' .. Depth ~- . ..... Height .......... ~ .... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i' · · Height ....................... Number of Stories .............. ,.,,~r .... 8. Dimensions of entire new constmction Front .~.~"7. Rear . ~..~... .Depth ~..~.t..~... , Height ............... Numberpf Stones../. ............. ,~ ........................ ,~-. ............ 9. Size of lot: Front .... /.~/,-..O7. ......... Rear . ./...~.. ............ n~-th ./.~.~, ......... ... 10. Date of Purchase .......... ; .................. ~Nitme of Former Owner' .~.~*~.. ~/~... 11. Zone br use district in which pfemises are situated i~,f".~..~...~.~r./ . 12. Does proposed construction vi41ate any zoning law, ordinance or regulation: ..~ ........................... 13. Will lot be regraded .... ff~O.~,, ..... ,~ .......... Will exc~ss~ll be removed from premises: _ (~. No 14. Name of Owner of premises .. :. ~f//*2.. ~. Address .~...~:~.. (-~45./~. ,g~.O~t~hone No..~.'~.~.~7:~,~. Name of Architect . .~ ..... ~ .............. Address .2. ................. Phone No ..... L. ......... Name of Contractor .'C... Address PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, iS.S COUNTY OF ................. i ............................. ' .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the . .: ................... of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith, Sworn to before me this i ....... :..(~..~. dayo!..~ ,197..~ ~ ........ ........... .... ,nt, NOTARY PUBLIC, State of Ne~? York · Term Expires Nlarch 30, 19,~'.~'' PLEAS~E NO~E the applicant's responsibility to maintain adequate sanitary distance between a~ water supp{y ~nd sewage disposal facilities, · © ~LE FAMILY DWELLING ONLY SURVEY FOR THOMAS H. GANNON, JR. AT LAUREL TOV/N OF $OUTHOLD SUFFOLK COUNTY, NEW YORK OATE= SCALE: NO. eUARANT£ED ESTATI AUGUST 1,1984 I" =~0~ 84 - 804 PLEASE NOTE the applicant's responsibility to maintain adequate sanitary distance between all water supply and sewage disposal facilities. ,/ SINGLE FAMILY DWELLING ONLY ~ SUFFOLK COUNTY DEP/,':",','"::4T OF HEALTH S,_,:~q' '"' J THOMAS H. GANNON, JR. FOR ~PROVAL OF CO,...,d~UCTlO,4 O, I.¢ ~ AT LAUREL ~ ~ ~ HS ~r ..... NO [~ ~_ 0 ~ ~ SUFFOLK ~OUNTY, NEW ~RK DATE ~ /~ J ~ ~. [ gUARANT~D TO / ~ ~_ ~ ~ ~ ~ ~ J SURVEY ~ A VI~ATION ~ ~ECTION 7~09 ~ THE I ~A~ ~A~ M~M~//~ APPROVED ~ ~ [ ~( ~ ~ '---~. ,. ~ NEW YORK STATE ~E~CATI~ LAW ~ / --~ --~ ~ It~/J ffCOP ES ~ ~1~ S~VEY NOT ~AR~G THE kAND HEA~ DGPARTMENT-D TA F~ APP ~ TO G~STRUCT / AND m HIS BEHALF ~ THE TITLE C~PMY ~OV~N J - - JJ J, J J ALDEN W.YOUNG, P~FESSION~L EN~JNJ[~ J, IN~L~(WI, M~ICTANKIITIJCim~I(eIWN~flJ~ J[ J ~J N.Y.S. LICENSE N0.45893 ' ' , J': M[ ~ FIJ~ ~MTI~S ~ O~ DATA OBTW~O Fff~ OTHEN S , ' · TITLE NO. T- 1284- 4432 a~SEP 30 1985. ~. D. ~. a~~ THOMASH, GANNON, JR,APR. _ _ , OC~ IO~ 1984 ~ a~ase a~a~e~ ~ ~e~ ~ ~T LAUREL O~TE' AUGUST facilities for t~iu locatio~ ~e b~ ~WN ~ SOUTHOLD SCAL~: I" =30' ~eet~ b~ [h~ ~e~a~ ~ to~ SUFFOLK COUNTY, NEW ~K NO. e4-~ ~GUARANTEE~ INDICTED HERZON ~ALL RUN ~LY ~ HEAL~ DEPARTMENT-OATA'F~ APPRO~L ~ C~ST~UC T ~[ ~R~ FOR WHOM THE SU~EY IS '" YOUNG YOUNG NOTE~ ~=MONUMENT TOT~AR~A= 17~OIl&~ O=PIPE ALOEN W, YOUNG, PROFESSlONAL ENGINEER AND LAND SURVEYOR N,Y.S. UCENSE NO, ,HOWARD ~, YOUN~ LANO SURVEYOR ~ ~ C~ ~ ~L(W~,~C rAN~(~a C[~OLS(~ ~N ~ N.~ S. LI CENS E NO. 45893